Prader-Willi syndrome( PWS) is a type of genetic disease,which is associated with low mus-cle tone,growth and development,progressive fatal obesity and sleep related respiratory disorders(SRBD). Ob-structive sleep apnea hypopnea syndrome( OSAHS) is the most common type of SRBD. The cause,influencing factors and treatment of OSAHS in patients with PWS are described in this paper. To understand the degree of OSAHS in children with PWS,the polysomnography is recommended.

With the widespread adoption of screening mammography, the incidence of ductal carcinoma in situ (DCIS) has been dramatically increased. The spectrum of local treatment advances from mastectomy to breast conservation surgery plus whole breast irradiation (WBI), and hypofractionated WBI or accelerated partial breast irradiation. Although the efficacy of WBI on reducing local recurrence is clear, such benefit in the low-risk DCIS is still controversial. Further studies are required to establish a more precise local recurrence risk stratification system for better tailoring local treatment in patients with DCIS. In this review, the latest advances and controversies in surgery, radiation therapy and local recurrence risk stratification system for patients with DCIS were summarized.

Objective To investigate the value of spiral CT for the diagnosis and treatment of congenital anorectal malformations (CARM). Methods Thirty children with CARM underwent lateral upside-down plain film in abdomen and spiral CT scanning in pelvic cavity before surgical operation. The distance between rectal blind end and anal fossa in two imaging modalities was measured. The correlation between the measurement results in two imaging modalities was compared with operational results. Sacral deformation was diagnosed according to 3D reconstruction of CT images. Results The measurement results obtained from CT were correlated positively with those of operation (r=0.99, P<0.01). CARM combined with curved sacrum was diagnosed in one child. No correlation was found between the measurement results of X-ray and operation (r=0.31, P>0.05). Conclusion Spiral CT scanning can accurately describe the atresic level of rectum and malformation of sacrum. It can provide reliable evidence for surgeon to choose the best surgical method and to judge prognosis.

A novel solid-phase extraction (SPE) adsorbent for simultaneous extraction of atrazine (ATZ) and its metabolites, deisopropylatrazine (DIA) and deethylatrazine (DEA) from environmental water samples was prepared. Polyacrylonitrile nanofibers (PAN NFs) mat was prepared via electrospinning, and was further functionalized to obtain polypyrrole modified polyacrylonitrile nanofibers (PPy-PAN NFs) mat, hydrazine modified polyacrylonitrile nanofibers (NH2-PAN NFs) mat and carboxyl modified polyacrylonitrile (COOH-PAN NFs) mat. The results showed that the adsorption capacity of COOH-PAN NFs mat was better than other three NFs mats in both static (2.0 mg/g) and dynamic (0.19 mg/g) experiments. Meanwhile, the runoff ratios of COOH-PAN NFs mat were the lowest (less than 30.0％) in the adsorption of three analytes, especially for high polar analytes, which showed that the hydrogen bond between carboxyl groups and analytes was the main interactive force. A combination of mat-based SPE and high performance liquid chromatography-diode array detection was further established for determination of 3 analytes in environmental water samples. The recoveries were 81.4％-120.3％ and the limits of detection were 0.12 ng/mL for DIA, 0.09 ng/mL for DEA and ATZ, respectively.

Objective To compare the efficacy and safety of liquid nitrogen cryotherapy combined with acyclovir and mecobalamin in the treatment of herpes zoster in elderly patients.Methods 520 elderly patients with herpes zoster were randomly divided into two groups,experimental group and control group (n=260,each).Patients in experimental group were treated with liquid nitrogen cryotherapy,using liquid nitrogen cotton swab to graze the skin lesions 2-3 times per day for successive 5 days,combined with acyclovir and mecobalamin.Patients in control group were treated with acyclovir and mecobalamin.New blisters and dry skin and crust were observed and compared between the two groups on the 5th,14th,30th day after treatment.The skin lesion situation and reaction times for pain complete remission,vesicular scab,postherpetic neuralgia (PHN) were recorded and analyzed.Results The effective rate was 93.9％ (244/260) in the experimental group versus 84.2％ (219/260) in the control group (x2 =12.32,P＜ 0.05).The reaction times for vesicular scab,pain complete remission and subside were shorter in experimental group than in control group [(2.63 ±0.78)d vs.(4.75±1.39)d,(8.17±1.68)d vs.(11.25±2.23)d,(9.24±2.53)d vs.(12.78±3.13)d,all P＜0.01].There was no significant difference in new blister time between the experimental group and the control group [(1.85±0.62) d vs.(1.79±0.83)d,P＞0.05].Postherpetic neuralgia incidence was lower in experimental group than in control group [6.9％ (18/260) vs.18.1％ (47/260),x2 =14.79,P＜0.01].Conclusions Treatment with liquid nitrogen cryotherapy combined with acyclovir and mecobalamin can shorten the reaction times of vesicular scab,and pain complete remission and subside,and reduce postherpetic neuralgia as compared to acyclovir and mecobalamin treatment in elderly patients with herpes zoster.

Background and purpose:Extranodal natural killer/T-cell lymphoma (ENKTL) is a form of non-Hodgkin’s lymphoma. The ENKTL incidence in China is much higher than that in the Western countries. The disease is highly malignant, not sensitive to chemotherapy, has short survival period and poor prognosis. Epstein-Barr virus (EBV) infection has close relationship with the development of the disease. However, there are still a few patients without EBV infection. This study aimed to discuss the clinical features and prognosis of EBV-encoded small RNA (EBER) in situ hybridization negative ENKTL.Methods:From Aug. 2011 to Oct. 2015, 326 cases were diagnosed with ENKTL from the First Affliated Hospital of Zhengzhou University. The expression of EBER was detected by in situ hy-bridization technique. The clinical pathological characteristics and prognosis of EBER-negative patients were analyzed. Results:In 326 patients with ENKTL, the negative rate of EBER was 2.45% (8/326). In 8 EBER-negative patients, the median survival time was 17 months. The log-rank test revealed that there was a signiifcant difference between EBER-negative and EBER-positive curves (χ2=6.407,P=0.011). Multivariate Cox proportional hazards regression analysis showed that in EBER-negative ENKTL, only lactate dehydrogenase (LDH) predicted survival time (P=0.008). EBV-DNA copy number in plasma was not signiifcantly correlated with survival time (P>0.05).Conclusion:The inci-dence of EBER-negative ENKTL is low. Patients with EBER-negative ENKTL have poorer prognosis than EBER-posi-tive patients. Elevated LDH may be a factor indicating poor prognosis.

Objective:To analyze clinical characteristics, treatment, and prognosis of B-cell lymphoma, unclassifiable, with features in-termediate between diffuse large B-cell lymphoma and Burkitt lymphoma (DLBCL/BL). Methods:The clinical and pathological data of 13 DLBCL/BL patients, who were treated in the First Affiliated Hospital of Zhengzhou University between January 2013 and December 2014, were collected. Overall survival (OS) and progression-free survival (PFS) were estimated by the Kaplan-Meier method. Through the log-rank test, survival curves were compared among groups classified by clinical stage, age, serum lactate dehydrogenase (LDH) lev-el, international prognostic index (IPI) score, or first chemotherapy regimen. Results:Among the 13 patients with DLBCL/BL, 12 pa-tients showed extra-nodal involvement. The median OS and PFS were only 10 and 6 months, respectively. Univariate analysis showed that the LDH levels and IPI scores exerted statistically significant effects on prognosis. Some borderline differences in survival were not-ed among the CHOP, CHOP-like, and intensive chemotherapy groups. Conclusion:DLBCL/BL is an aggressive B-cell lymphoma with a short survival time. The majority of patients presented extra-nodal involvement. DLBCL/BL did not respond well to CHOP or CHOP-like regimen, and more intensive chemotherapy may improve survival. Elevated LDH levels and high IPI scores were predictors of poor sur-vival.

Objective To explore the effects of combination of traditional Chinese medicine (TCM)and western medicine on a variety of allergen induced severe perennial seasonal allergic rhinitis patients who were treated invalidly with antihistamines and intranasal flixonase for more than two years.Methods 16 patients with moderate to severe allergic rhinitis who were uncontrolled with antihistamines and intranasal flixonase for one week were treated by combination with TCM of Xin-Yi-Qing-fei San or Gyokubeifu-san mixed formula for two weeks.Nasal symptoms,its effects on the quality of daily life,and telephone follow-up half a year later were evaluated.Mini Rhinoconjunctivitis Quality of Life Questionnaire (Mini-RQLQ) and Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire (NRQLQ) were used to evaluate the quality of life.Results After 2 weeks combination-treatment,the nasal symptoms of congestion,rhinorrhea,sneezing,nasal itching,and nasal obstruction were significantly improved compared with combination-before [(52.0± 11.1)％,(69.1±5.3)％,(68.3±12.3)％,(55.5±10.0)％to (10.9±2.4)％,(8.9±3.2)％,(12.5±4.3)％,(13.2±5.3)％,respectively].The before and after treatment of nasal function of nasal minimum cross-sectional area (MCA),nasal cavity volume (V5) and nasal airway resistance (R75 and R150) respectively were (0.58±0.12)cm2,(0.38 ± 0.23) Pa/cm3 · s-1,(0.44 ± 0.32) Pa/cm3 · s-1,(3.50 ± 2.33) cm2 to (0.48 ± 0.23) cm2,(0.31 ±0.33) Pa/cm3 · s-1,(0.31 ±0.37)Pa/cm3 · s-1,(2.24± 1.03) cm2 (P＜0.01).In addition,findings of patients with nasal symptoms by half year follow-up were significantly better than those of before.Conclusion The interventionof TCM can effectively control the perennial and seasonal severe symptoms of patients with AR,and improve the quality of life of patients.

Objective To study MRI manifestations of cerebral developmental venous anomaly (DVA)and to analyze the diagnos-tic value of different sequences.Methods Conventional MRI and contrast enhancement 3D-T1 WI were performed in all 10 patients who were collected in our hospital.Among the 10 cases,6 patients underwent MRA and 4 patients underwent MRV.The diaplay of the draining veins and medullary veins were assessed.Results All 10 cases were sporadic lesion,the lesions of 9 cases were located in supra tentorium and which of 1 case was located in infra tentorium.Abnormal signals without characteristics of draining veins in 6 cases and dilated medullary veins in 4 cases were found in conventional MRI,while 6 draining veins showed flow void signal on T2 WI and 3 of the 4 medullary veins showed hypointensity on T1 WI and hyperintensity on T2 WI.Contrast enhancement 3D-T1 WI displayed the markedly enhanced draining veins and dilated medullary veins in all 10 cases of DVA.Numerous medullary veins gath-ered together into large draining veins radially and flowed into superficial or deeper veins,so-called“caput medusae”appearance were found as the characteristics in all cases.MRA and MRV revealed draining veins only partially but no medullary veins.Conclusion MRI could diagnose DVA clearly,the sensitivity of detecting DVA on conventional MRI is low and there are no characteristics ap-pearances.Contrast enhancement 3D-T1 WI is the most accurate and sensitive method,MRA and MRV are not highly worthwhile for diagnosing DVA.

Objective To study the predictive validity of fidgety general movement assessment in pre-term twins and multiplets for motor development outcomes.Methods A total of 53 pre-term twins or multiplets delivered between July 2011 and February 2016 participated in this study.They were assessed using a general movements (GM) assessment and participated in the follow-up program until one year old.The motor development outcomes of the infants at one year old were determined according to clinical diagnoses and the Peabody developmental motor scale number two (PDMS-2) evaluation.The predictive validity of fidgety general movement assessment for motor development outcomes was calculated against the standard motor development of infants at one year old.Results There were 53 twins or multiplets who accepted the GM assessment of fidgety movement period.Of these,43 were assessed as normal (NF) and ten (19％) as lacking a normal level of fidgety movement (F-).All 53 cases were followed-up for the motor development outcome.Forty-three cases (81.1％) were assessed as normal at one year old,while ten (18.9％) were assessed as abnormal.All ten had cerebral palsy,and no motor development retardation was found.The predictive value of F-for cerebral palsy was 90.0％ in terms of sensitivity,97.7％ in terms of specificity,90.0％ in positive predictive value,and 97.7％ in terms of negative predictive value.Conclusions Among pre-term twins or multiplets,the fidgety general movement assessment can be a useful early indicator of motor development difficulties.